Provider Demographics
NPI:1225222987
Name:WARD, DAVID J (LCSW)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:J
Last Name:WARD
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:972 CHAMBERS ST
Mailing Address - Street 2:SUITE 5
Mailing Address - City:SOUTH OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84403-4872
Mailing Address - Country:US
Mailing Address - Phone:801-476-6916
Mailing Address - Fax:
Practice Address - Street 1:972 CHAMBERS ST
Practice Address - Street 2:SUITE 5
Practice Address - City:SOUTH OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84403-4872
Practice Address - Country:US
Practice Address - Phone:801-476-6916
Practice Address - Fax:801-476-6990
Is Sole Proprietor?:No
Enumeration Date:2007-09-05
Last Update Date:2009-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT286752-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical